Stringent COVID-19 control measures were imposed in Wuhan between January 23 and April 8, 2020. Estimates of the prevalence of infection following the release of restrictions could inform post-lockdown pandemic management. Here, we describe a city-wide SARS-CoV-2 nucleic acid screening programme between May 14 and June 1, 2020 in Wuhan. All city residents aged six years or older were eligible and 9,899,828 (92.9%) participated. No new symptomatic cases and 300 asymptomatic cases (detection rate 0.303/10,000, 95% CI 0.270–0.339/10,000) were identified. There were no positive tests amongst 1,174 close contacts of asymptomatic cases. 107 of 34,424 previously recovered COVID-19 patients tested positive again (re-positive rate 0.31%, 95% CI 0.423–0.574%). The prevalence of SARS-CoV-2 infection in Wuhan was therefore very low five to eight weeks after the end of lockdown.

With the rapid development of the modern economy and society, the social and natural environment is also undergoing rapid changes, and people’s lifestyles are subsequently transformed. Sleep disturbances have become an important public health problem worldwide affecting people’s physical and mental health. There is established epidemiological evidence that inadequate sleep duration and poor sleep quality […]

To determine the prevalence of and factors associated with dispensing antibiotics without a prescription in online and community pharmacies in China. We conducted a nationwide cross-sectional study of online and community pharmacies in 27 cities and counties in nine provinces in China (selected by multistage sampling) from July 2017 to December 2018. We assessed sale of antibiotics without a prescription and quality of pharmacy services through simulated clients who asked to buy specific antibiotics. We compared the prevalence of sales between online and community pharmacies, and between location and features of community pharmacies. Of 220 online and 675 community pharmacies, 174 (79.1%) and 586 (86.8%) sold antibiotics without a valid prescription, respectively. About half of the online pharmacies had a notice on their website about the illegality of selling prescription-only medicines without a prescription while none of the community pharmacists had. More online pharmacies without this notice dispensed antibiotics without a valid prescription (P < 0.001). Antibiotics’ sale without a prescription was significantly less prevalent in provincial capital cities (71.6%; 161/225) than prefectural-level cities (95.1%; 214/225) and counties (93.8%; 211/225; P < 0.001). Most pharmacy staff did not ask for important information from clients before dispensing the antibiotic or provide them with necessary information about the antibiotic. Given the high proportion of sales of prescription-only medicines without a prescription, there is a need to strengthen enforcement of regulations, improve public education on antibiotics, train pharmacy staff and consolidate public involvement in antibiotic stewardship in retail pharmacies in China.

Data surveillance and policy interventions can optimize antibiotic use, but few studies have focused on the changes in antibiotic use after a strict antibiotic stewardship policy was implemented in China in 2012. Based on the Center for Antibacterial Surveillance, data were collected from general hospitals in two provinces of China. Using indicators (e.g. percentage of antibiotic use and proportion of antibiotic costs) recommended by the WHO, this study aimed to identify trends and patterns of systemic antibiotic (Anatomical Therapeutic Chemical code J01) use in hospitals in 2012-16 and to explore inappropriate antibiotic use. This study obtained 282479 outpatient prescriptions and 86070 inpatient records from 52 hospitals. The percentage of antibiotic use in outpatients and non-surgical and surgical inpatients significantly declined from 20.17%, 41.92% and 74.15% in 2012 to 12.94%, 33.88% and 69.03% in 2016, respectively. Among antibiotic prescriptions and records, the percentage of antibiotic combination therapy, the percentage of antibiotic use for prophylaxis and the proportion of antibiotic costs showed a decreasing trend over time. However, in 2016, the percentage of antibiotic use for surgical prophylaxis was still >80%, with more than one-third involving inappropriate timing of antibiotic usage according to the predefined criteria. In non-surgical inpatients, the usage rates in acute upper respiratory infections, diarrhoea in children <5 years and fever or cough symptoms all exceeded 55%. A significant downward trend in antibiotic use was identified in China's hospitals, which indicates that policy intervention might reduce the overuse of antibiotics. Furthermore, strengthening appropriate antibiotic use should be the focus of antibiotic stewardship.